Senators Press Medicare for Answers on Drug Program

Sen. Tom Carper, D-Del., who chairs the Homeland Security and Governmental Affairs Committee, said in a statement that he plans to ask Medicare officials and the inspector general of the U.S. Department of Health and Human Services “to look into the specifics of these cases, as well as determine the extent of any program-wide vulnerabilities that may have allowed them to occur.” The committee monitors fraud in government programs.

ProPublica reporters, using Medicare’s own data, identified scores of doctors whose prescription patterns within the program bore the hallmarks of fraud. The cost of their prescribing spiked dramatically from one year to the next — in some cases by millions of dollars — as they chose brand-name drugs that scammers can easily resell.

The cost of medications prescribed by one Miami doctor jumped from $282,000 to $4 million in one year, but her lawyer said Medicare never questioned it. A Los Angeles psychiatrist said Medicare didn’t shut off his provider identification number, used to fill prescriptions, even though he claimed someone had forged his name on more than $7 million worth of them.

All told, just the schemes identified by ProPublica totaled tens of millions of dollars.